Trt labs suggestions

[xxblazenlowxx]

Just received my first labs today after starting trt. Looking for some advice im not feeling as great as when I first started and im wondering if I should increase my testosterone dose but how much?

36yo



My protocol now is
test cyp 50mg e3d
Hcg 250iu e3d
No a.i.

Blood work was taken 50hrs after last injection and i was fasting for almost 12hrs

Shbg 17.2 16.5-916. Nmol/l

Test serum 518. 264-916 ng/dl

Free test 18.8. 8.7-25.1. Pg/ml

Estradiol 29.9. 8.0-35.0 pg/ml

Hematocrit 47.6

Labcorp

I have another appointment to go over this with defy. Im woukd like to see some of your suggestions and also see what defy says to make an educated decision.

Should I be targeting specific numbers or going more by feel?

[Youthful55guy]

Please post the lab's normal ranges and the units for the tests. The results seems odd to me. The timing of the draw should put you at your peak levels, and 50 mg E3D should get you closer to 800-900 ng/dL. I am questioning whether low SHBG may be the problem. If the units are nmol/L, that's a very low level of SHBG. The normal range for LabCorp is 16.5 to 55.9 for 20-49 Years and 19.3 to 76.4 for >49 Years. Your goal is mid-range for 20-49 Y/O = ~36 nmol/L.

low SHBG will mean that the T is metabolized more quickly in the liver, hence low T levels even with a moderate to high dose (yours is a god moderate dose). There is no good way to increase SHBG. Your best bet is to go to subQ daily injections of smaller amounts. This will help maintain more stable T levels.


I have no experience with low SHBG (mine is too high). Perhaps there are others here who have had success with TRT and low SHBG that can chime in.

[xxblazenlowxx]

Thank you for your insight youthfull55.

I have updated my original post with the labs ranges and yes i do use labcorp.

Pinning daily would be no issue for me and I am currently pinning sub q

If for some reason i needed to pin daily would i also change the ester to a propinate or would the ester not matter?

[Youthful55guy]

Thank you for your insight youthfull55.

I have updated my original post with the labs ranges and yes i do use labcorp.

Pinning daily would be no issue for me and I am currently pinning sub q

If for some reason i needed to pin daily would i also change the ester to a propinate or would the ester not matter?

No, stick with T-cyp. You want the longest lasting ester you can get with low SHBG. Switching to T-prop will make it worse. I suspect your E2 might be low too given that you burn through T so rapidly, there's less converted to E2. Guys need a certain level of E2 too to fell normal and have normal erections (one of nature's cruel jokes).

[kelkel]

Thank you for your insight youthfull55.

I have updated my original post with the labs ranges and yes i do use labcorp.

Pinning daily would be no issue for me and I am currently pinning sub q

If for some reason i needed to pin daily would i also change the ester to a propinate or would the ester not matter?

I would not jump into pinning daily unless absolutely necessary, imho. When it comes to how you feel remember, you just started so your body is still searching for homeostasis. Initiating TRT doesn't mean you'll feel good in 6 weeks and all is better. It can take literally months (6+) for some men to fully dial in and realize (feel) the benefits of TRT, even though numbers may look perfect. When you initially begin TRT many men feel great and then it subsides. This can simply be due to an influx of dopamine due to the new level of testosterone . It then finds a balance and that euphoric feeling settles down unfortunately.

TRT does not guarantee feeling good all the time. No matter what medications we are on we can all have off days/weeks.

Be patient with what you do. I'd simply suggest upping your dose slightly.

[Youthful55guy]

I would not jump into pinning daily unless absolutely necessary, imho. When it comes to how you feel remember, you just started so your body is still searching for homeostasis. Initiating TRT doesn't mean you'll feel good in 6 weeks and all is better. It can take literally months (6+) for some men to fully dial in and realize (feel) the benefits of TRT, even though numbers may look perfect. When you initially begin TRT many men feel great and then it subsides. This can simply be due to an influx of dopamine due to the new level of testosterone . It then finds a balance and that euphoric feeling settles down unfortunately.

TRT does not guarantee feeling good all the time. No matter what medications we are on we can all have off days/weeks.

Be patient with what you do. I'd simply suggest upping your dose slightly.

Respectfully, Kel I disagree on this one. With a SHBG of 17.2 on a 16.5-91.6 normal range, I'm willing to bet it's why he gets a peek TT of only 518 on a 264-916 normal range. He should be topping out on the range with a dose of 50 mg E3D. Fortunately, his Free T is in range, but I suspect it drops to the bottom of the range by day 3. After reviewing his labs again, I see he does have E2 labs and they look good. So my suspicion of E2 being low was unfounded. In my opinion, I think increasing frequency rather than dose would be more beneficial with low SHBG.

However, I do agree that changes to the protocol should be made slowly and only with labs to justify the change. Also, you should give the protocol a minimum of 4 weeks (6 better) before running the labs.

[kelkel]

That may very well be the way to go eventually. My thinking is to keep it simple initially, that's all. He'll know in a month whether that works for him or not. Also depends on how enthused the op is about pinning. No doubt the lower shbg is leading to a faster metabolism of T but not (imho) to the level of a hyper-metabolizer.

[xxblazenlowxx]

Talked to defy today and they recommend the following

Test cyp 46mg eod
Hcg 300iu every other day

They also recconened an ia because this will most likely make my E2 higher.

Im going to get the ai but i dont think I will take it unless i feel the need to. Instead I will have blood drawn in 6 weeks and make a educated decsion on what and how much to do.

When looking at others regiments it appears my hcg is on the high side.

Defy recomended i do my injection 3 times a week m/w/f I thought that was not the best protocal for stable levels and they took my suggestion for every other day but lowered dose from 50mg test to 46 and raised my hcg from 250 to 300.

I do not understand the higher dose of hcg, especially since it easily converts to estrogen.

My intial though is to also lower my hcg to help keep estrogen in check without adding an ai

Any thoughts?

And thank you for your comments and suggestions so far, I appericate it.

[kelkel]

Thoughts would be to do exactly as they say and not manipulate things on your own. You'll know shortly how things are.
HCG also bumps up test.
Follow their AI recommendations. You won't always be able to "feel" the need.

[xxblazenlowxx]

Up dated blood work

Regiment
Test cyp every other day 46 MG
HCG every other day 300 IU
No ai

Blood work results

Actual Normal range
SHBG. 13.9. 16.5-59.9

Test serum 699. 264-916

Free test 29. 8.7-25.1

Estradiol 45.8. 8-35

Hematocrit 50.5. 37.5-51

I have an appointment with defy tomorrow but value the opinion of some of you and like to compare it to defy.

So what do you guys think?

[Tim1985]

Not sure if you told them you weren’t going to take the AI, but if they press you about getting your estrogen down, ask them about supplementing with DIM. My doc suggested it to me first and then we adjust additional AI as needed.

[xxblazenlowxx]

Thanks for the heads up Tim.

I brought it up to defy and they said to start at 100mg a day. See how i feel and follow up with blood work in 6 months or early if I choose.

Defy said even though my E2 is out of range since im not feeling any symptoms i should be fine.

My hcg has also been lowered to 200iu every other day.

Fish oil from 2g a day upped to 5g a day

[Youthful55guy]

Thanks for the heads up Tim.

I brought it up to defy and they said to start at 100mg a day. See how i feel and follow up with blood work in 6 months or early if I choose.

Defy said even though my E2 is out of range since im not feeling any symptoms i should be fine.

My hcg has also been lowered to 200iu every other day.

Fish oil from 2g a day upped to 5g a day

By 100 mg/day, I'm assuming that is for DIM. If so, the dose is on the low side, but then again your E levels are not that high to begin with, so a low dose of DIM might be the right place to start. Low E values by overshooting the mark is worse that borderline high levels.

Personally, I would not have changed the HCG dose, but 200 IU E2D is still a good dose.

[xxblazenlowxx]

By 100 mg/day, I'm assuming that is for DIM. If so, the dose is on the low side, but then again your E levels are not that high to begin with, so a low dose of DIM might be the right place to start. Low E values by overshooting the mark is worse that borderline high levels.

Personally, I would not have changed the HCG dose, but 200 IU E2D is still a good dose.

Yes 100mg of DIM a day but I purchased 150mg so Thats what im taking each night before bed